Osteochondritis dissecans is a painful joint problem. It’s most common in children and teens who are active in sports. The condition happens most often in the knees, but your child can also have it in the elbows, ankles, and other joints.
Most of the time, it gets better when you rest the joint for a while. But your doctor can recommend other things that can help, too.
The problem begins when the bone under the firm, thick tissue in a joint, called cartilage, doesn’t get enough blood flow. That can cause the bone to die. When it does, the bone and cartilage can break loose. This can be painful and can keep your child from moving that joint very well.
Doctors don’t know exactly what causes blood to stop flowing to a part of a bone, but many think it happens after too much stress on the joint. Kids can get osteochondritis dissecans after an injury or when they spend months doing high-impact activities such as running and jumping.
Other symptoms can include:
- Weakness in the joint
- You can’t straighten the joint
- It pops or locks in one place
Getting a Diagnosis
If your child’s joint pain doesn’t get better or she can no longer move the joint through its full range of motion, you should make an appointment with her doctor.
He will do a physical exam and may also order an X-ray or another scan to get a look inside that area.
He’ll check to see whether the bone fragment has broken off partly or completely and if that piece moves inside the joint or not.
Before you see your child’s doctor, make a note of her symptoms, when they started, and whether they could be related to an injury.
The goal of treatment is to ease pain and get your child back to using her joint normally.
For most kids and young teens with osteochondritis dissecans, the bone can heal on its own with rest and by protecting the joint. This might mean your child has to wear a splint, cast, or brace or use crutches for a few weeks.
Another option is physical therapy to strengthen the joint and improve how well it moves.
Your child will likely start feeling better after 2 to 4 months of rest and therapy.
However, some children need surgery if:
- The pain doesn’t get better
- The bone fragment gets stuck in the joint
- The broken piece is moving around in the joint
- The fragment is larger than 1 centimeter (just under half an inch), especially in older teens.
Many doctors will want to try other treatments for 4-6 months before they recommend surgery.
Surgery for Osteochondritis Dissecans
There are several types of surgery that can help. They include:
- Drilling into the bone in the joint to create new ways for blood to flow there
- Using pins or screws to keep the dead bone in place
- Replacing the damaged bone or cartilage with new tissue, called a graft. This can cause healthy bone to grow.
After surgery, your child will have to rest the joint and then do physical therapy to build up its strength and range of motion.
Many kids can gradually start to play sports again 4 to 5 months after surgery.